Prevalence of Eyelash Demodex among Human Immunodeficiency Virus Infected Patients at Different CD4+ Count Status.

Sir,

The trichological disorder among human immunodeficiency virus (HIV) infected patients is an important concern. There are many possible problems especially for the fungal infection.[1] Focusing on parasitic infestation, it is usually less mentioned. Apart from the well-known diseases, louse and scabies infestations, there are also others. Demodex infestation is a hair infestation that can be seen around the world. The common site of infestation is at eyelash and it can result in folliculitis and other more serious clinical problems (such as blepharitis). In a recent report from Mexico, nearly 20% of general population got this parasite.[2] For HIV infected patients, a previous report showed that the prevalence was estimated 20%.[3] Focusing on the HIV infected patients, there has never report on the rate of eyelash demodex and its interrelationship with CD4+ count. Here, the authors performed a small preliminary survey on 60 HIV infected patients (20 cases with CD4+ count <200 cells/mL, 20 cases with CD4+ count between 200 and 500 cells/mL and 20 cases with CD4+ count >500 cells/mL). The rates of eyelash demodex are equal to 95%, 70% and 20%, in the cases with CD4+ count <200 cells/mL, CD4+ count between 200 and 500 cells/mL and CD4+ count >500 cells/mL, respectively. It can be seen that there is a trend of increasing prevalence when the CD4+ count drops. In fact, there is a previous report mentioned for the relationship between increased dermatological disorder and decreased CD4+ count among HIV infected patients.[4]